Handout photo of Margot Bentley. In 1999, Margot Bentley, then in her late 60s, was diagnosed with Alzheimer's. She used to be a nurse who cared for Alzheimer's patients and wrote a living will that she should not receive medical care and be allowed to die.

Margot Bentley's living will.John Morstad
/ John Morstad

Katherine Hammond with a photo of her mother, Margot Bentley, who has advanced Alzheimer’s. Hammond and Bentley’s husband, John, contend the wishes of Margot’s living will are not being met.John Morstad
/ John Morstad

Margot Bentley.Katherine Hammond
/ handout

Margot Bentley with her grandchildren, it was taken in 1988, 3 years before she wrote her Living Will. Family handout.

The B.C. Supreme Court ruled Monday that the care and feeding of Margot Bentley, the 82-year-old Alzheimer's patient whose family insists is being kept alive against her will in an Abbotsford care home, must continue.

In his detailed 44-page decision, Supreme Court Justice Bruce Greyell also ruled that neither Bentley's "living will" she wrote out in 1991 or a subsequent written statement of her wishes when she was diagnosed with Alzheimer's in 1999 constituted "a valid representation or advance directive" to refuse care and be allowed to die.

Central to Justice Greyell's ruling was determining whether Bentley was capable of making the decision to accept food or drink. Her family, who brought the suit against Maplewood Seniors Care home, insisted that she was not capable because she was in a "vegetative state," and that when the care home staff pressed spoonfuls of food against her lips, she was only acting reflexively when she opened her mouth.

Greyell rejected the family's position.

"Based on the evidence before me," he wrote, "I am of the view that the petitioners have not met their onus of rebutting the legislative presumption that Mrs. Bentley is capable of making the decision to accept or refuse to eat and drink. The preponderance of the evidence demonstrates that she has the capacity to make this decision. In coming to this finding, I have carefully considered and weighed the medical evidence as well as the descriptions of Mrs. Bentley's behaviour ... I find it significant that Mrs. Bentley indicates preferences for certain flavours and eats different amounts at different times. The petitioner has not established that Mrs. Bentley's behaviour is a mere reflex and not communication through behaviour, which is the only means through which Mrs. Bentley can communicate."

Bentley's daughter, Katherine Hammond, was shocked by the decision.

"The judgment is a shock and a huge disappointment for me and my family," Hammond wrote in an email Monday, "and we all know that this outcome is not what my mom wanted.

"We think it is absurd that the judge found my mom capable of 'making decisions' and 'providing her consent through her behaviour' ... My mom has been unable to communicate in any way for many years. It has been 15 years since she was diagnosed with Alzheimer's and she is in the end stage, with confirmed severe dementia, bedridden, diapered, incapable of speaking or moving, eyes mostly closed, in a semi-conscious state."

In a subsequent phone interview, Hammond said she believed the court's decision to continue her mother's care was contrary to what actually, and quietly, happens in the health system.

"I'm a nurse and I know that people like my mom are allowed to die every day. It happens all the time. And none of us to this day know why there was intervention in my mom's situation, but we feel that someone in the care home definitely intervened, someone who had a different opinion around end-of-life care or someone who had religious beliefs. But in our opinion, as well intentioned as a care provider might be, it has nothing to do with them."

Hammond said she felt that rather than clarify the law regarding end-of-life care, the decision seemed to confuse the issue more than ever.

"I'm also frustrated with the law in that there still seems to be so much open to interpretation. It's unacceptable. We need clarity. Patients need clarity, doctors need clarity, and the situation is untenable. And there are more and more issues in the forefront today around people who want to determine end-of-life acre, so we need laws that are clear and that honour peoples' rights and that allow doctors freedom to support their patients in their decisions without fear of litigation."

Hammond, who at one point in the interview began to cry, said the family had not decided on a course of action.

"I grieve for my mom. So I don't know what we're going at do at this point. I talked to my father about it, and he's devastated. He promised my mom on several occasions that this would not happen, and so he feels very badly that he has not been able to do what she asked him to do."

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